title: Functional outcome of anatomic correction of corrected transposition of the great arteries.
abstract: OBJECTIVE
  Anatomic correction of corrected transposition of the great arteries, utilizing the morphologic left ventricle as a systemic pumping chamber, is considered the preferred method. The purpose of the study was to analyze the intermediate functional outcome following anatomical correction.
  
  
  METHODS
  Between 1997 and 6/2010, 23 patients with corrected transposition of the great arteries and associated lesions underwent anatomical correction. Seventeen (74%) and six patients (26%) had situs solitus {S,L,L} and situs invs {I,D,D}, respectively. Fifteen patients (65%) had undergone 18 palliations before the corrective operation. The median age at palliation was 0.23 years, with a range of 0.016-8.4 years. A corrective, modified Senning-arterial switch procedure was performed in nine patients, 13 patients underwent a modified Senning-Rastelli procedure, and in one patient a combination of modified Senning and aortic translocation (Bex/Nikaidoh) was used. The median age at the corrective operation was 2 years (from 0.3 to 15.7 years).
  
  
  RESULTS
  There was no mortality or heart transplant within the mean follow-up of 3.4 years. Freedom from reintervention was 77% at 5 years. There were no signs of obstruction of the systemic and pulmonary venous tunnels. The function of both ventricles was normal in all patients, even in the four patients who required retraining of the left ventricle. Mild aortic regurgitation was noticed in three patients. Preoperatively detected significant tricuspid regurgitation either disappeared or became trivial after the operation in all the six patients. All patients except two are in sinus rhythm; one patient is pacemaker-dependent preoperatively and one is pacemaker-dependent postoperatively. There were no clinically apparent neurological problems. All patients, but one, are in the New York Heart Association (NYHA) class I.
  
  
  CONCLUSIONS
  Anatomic correction of corrected transposition of the great arteries can be performed in selected patients without mortality and with acceptable morbidity. The mid-term functional outcome is excellent, resulting in normal ventricular function, even in retrained left ventricles, and minimal incidence of complete heart block. The long-term function of the aortic valve, intraventricular tunnels, conduits, and ventricles requires close surveillance.
authors.affiliation: German Pediatric Heart Centre, Asklepios Clinic Sankt Augustin, Arnold Janssen Str. 29, 53757 Sankt Augustin, Germany. v.hraska@asklepios.com
authors.forename: Viktor
authors.initials: V
authors.lastname: Hraška
authors.forename: Angela
authors.initials: A
authors.lastname: Mattes
authors.forename: Christoph
authors.initials: C
authors.lastname: Haun
authors.forename: Hedwiga Christine
authors.initials: HC
authors.lastname: Blaschczok
authors.forename: Joachim
authors.initials: J
authors.lastname: Photiadis
authors.forename: Peter
authors.initials: P
authors.lastname: Murin
authors.forename: Peter
authors.initials: P
authors.lastname: Zartner
authors.forename: Boulos
authors.initials: B
authors.lastname: Asfour
mesh_terms: D000293:Adolescent; D001022:Aortic Valve Insufficiency / Q000209:etiology; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D012086:Reoperation; D012189:Retrospective Studies; D014188:Transposition of Great Vessels / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D016276:Ventricular Function / Q000502:physiology; D014694:Ventricular Outflow Obstruction / Q000601:surgery